Treatment of recurrent bile duct stricture after primary reconstruction for laparoscopic cholecystectomy-induced injury.
Laparoscopic cholecystectomy (LC) has been accepted as a primary treatment modality for various benign gallbladder diseases. However, bile duct injury has occurred in a non-negligible proportion of patients who undergo LC. The outcome of primary reconstruction for LC-induced major bile duct injuries is usually favorable, but a small proportion of patients revealed serious biliary stricture during follow-up. We described the experience on the treatment for such delayed-onset bile duct strictures that occurred in 5 patients. One patient showed biliary strictures 6 months after primary hepaticojejunostomy, which were successfully treated with radiologic intervention. Other 4 patients underwent right lobectomy and redo hepaticojejunostomy 4 to 16 months after primary biliary reconstruction. No recurrent biliary stricture occurred during mean follow-up of 40 months. In conclusion, prolonged surveillance over 5 years seems necessary for the detection of delayed-onset biliary stricture after primary biliary reconstruction. Delayed-onset bile duct stricture should be treated on the case-by-case basis, with radiologic intervention or radical biliary reconstruction combined with liver resection.
Hwang
Shin
S
Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. shwang@amc.seoul.kr
Lee
Sung-Gyu
SG
Lee
Young-Joo
YJ
Ahn
Chul-Soo
CS
Kim
Ki-Hun
KH
Moon
Deok-Bog
DB
Ha
Tae-Yong
TY
D000328:Adult; D001652:Bile Ducts / Q000293:injuries / Q000601:surgery*; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects*; D002779:Cholestasis / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D008875:Middle Aged; D012008:Recurrence